Bimalleolar fracture

Bimalleolar fracture
Synonyms	Pott's fracture
Pronounce	N/A
Specialty	Orthopedic surgery
Symptoms	Pain, swelling, bruising, inability to bear weight
Complications	Post-traumatic arthritis, chronic pain, instability
Onset	Sudden, usually due to trauma
Duration	Varies, depending on treatment and rehabilitation
Types	N/A
Causes	Ankle injury, typically from twisting or impact
Risks	Osteoporosis, high-impact sports, falls
Diagnosis	Physical examination, X-ray, CT scan
Differential diagnosis	Unimalleolar fracture, trimalleolar fracture, ankle sprain
Prevention	N/A
Treatment	Immobilization, surgery, physical therapy
Medication	N/A
Prognosis	Generally good with appropriate treatment
Frequency	Common in sports injuries and falls
Deaths	N/A

A type of ankle fracture involving two malleoli

Bimalleolar fracture is a type of ankle fracture that involves both the medial malleolus and the lateral malleolus. This injury is commonly associated with ankle sprains and can result from a variety of mechanisms, including twisting injuries, falls, or direct trauma to the ankle.

Anatomy of the Ankle

The ankle joint is a complex structure that includes the tibia, fibula, and talus. The medial malleolus is the distal end of the tibia, while the lateral malleolus is the distal end of the fibula. These structures form a mortise that articulates with the talus, allowing for the movement of the foot.

Mechanism of Injury

Bimalleolar fractures typically occur due to a rotational force applied to the ankle. This can happen during activities such as running, jumping, or slipping on an uneven surface. The force causes the ankle to twist, leading to fractures of both the medial and lateral malleoli.

Clinical Presentation

Patients with a bimalleolar fracture often present with severe pain, swelling, and inability to bear weight on the affected limb. There may be visible deformity of the ankle, and bruising may develop around the joint. Physical examination typically reveals tenderness over the malleoli and limited range of motion.

Diagnosis

Diagnosis of a bimalleolar fracture is confirmed through radiographic imaging. X-rays of the ankle are taken in multiple views to assess the extent of the fracture and any associated dislocation. In some cases, a CT scan may be necessary to evaluate complex fractures.

Treatment

The treatment of bimalleolar fractures depends on the severity and displacement of the fracture. Non-displaced fractures may be managed conservatively with immobilization in a cast or splint. However, most bimalleolar fractures require surgical intervention to realign and stabilize the bones.

Surgical Treatment

Surgical options include open reduction and internal fixation (ORIF), where the bones are repositioned and held in place with plates and screws. The goal of surgery is to restore the normal anatomy of the ankle joint and allow for proper healing.

Rehabilitation

Post-operative rehabilitation is crucial for recovery. Patients typically undergo physical therapy to regain strength, flexibility, and range of motion in the ankle. Weight-bearing is gradually introduced as healing progresses.

Prognosis

The prognosis for bimalleolar fractures is generally good with appropriate treatment. Most patients can return to their normal activities, although some may experience residual stiffness or discomfort. Complications such as post-traumatic arthritis can occur, particularly if the joint surface was involved in the fracture.

Related Pages

• Ankle fracture
• Medial malleolus fracture
• Lateral malleolus fracture
• Trimalleolar fracture